In many surgical procedures, a scoping device is used to view, engage, and/or treat tissue in a number of ways to achieve a diagnostic or therapeutic effect. In endoscopic procedures, the scoping device is inserted through a natural orifice, such as the mouth, anus, vagina, or urethra, and is advanced along a natural lumen or other pathway to position a distal end of the device at a surgical site. In laparoscopic procedures, one or more small incisions are formed in the patient and a trocar or other device is inserted through the incision to provide a working channel into a body cavity, through which the scoping device can be passed.
Endoscopic procedures often require the use of a flexible shaft to accommodate a tortuous pathway through a body lumen or other pathway to the surgical site. The flexibility of such scoping devices makes them very useful for diagnosing, evaluating, or operating within body lumens. Once the scope exits the constraints of a lumen however, the flexible nature of the scope makes maneuvering difficult. The scope tip can be actively articulated as it is advanced in the patient's body, however the flexible portion of the scope proximal to the articulating tip can passively bend or buckle unpredictably.
For example, in many procedures performed within the peritoneal cavity, the patient is placed in a supine position and the peritoneal cavity is insufflated. Gravity causes the organs within the cavity to lie on the cavity's dorsal wall. A surgeon attempting to access a surgical site within the cavity with a scoping device using either a transvaginal or transrectal approach must push the scoping device through these organs, along the dorsal wall of the cavity. Successfully pushing a flexible scoping device through such obstacles can be incredibly difficult and time-consuming, as the tendency is for the scope to simply coil up, rather than to push through the organs.
In addition, it is often desirable in endoscopic and other minimally invasive surgical procedures to have a leverage point within the patient for manipulating surgical tools, implants, or tissue. A flexible scoping device, by itself, does not provide adequate leverage at its distal end for performing such manipulations.
Accordingly, there is a need for improved methods and devices for efficiently guiding scoping devices to a surgical site and for manipulating objects or tissue within a patient.